Hull Royal Infirmary: ‘Chaotic’ hospital maternity unit deemed ‘not fit for purpose’ by health watchdog

A maternity unit in the UK has been deemed “not fit for purpose” after it was given the lowest possible rating by the health watchdog.

Hull Royal Infirmary, which forms part of the Hull University Teaching Hospitals NHS Trust, was visited on 15 March, 24 April, and 25 April by the Care Quality Commission (CQC) as part of a national maternity inspection programme. Following the visits, the hospital’s maternity unit had its rating downgraded from ‘good’ to ‘inadequate’.

Inspectors described the unit’s environment as “chaotic” - reporting that dangers were “not well managed”, there were lengthy delays in pregnant women being seen, and staff were not completing adequate risk assessments or “acting quickly to prevent deterioration of women and birthing people”.

Concerns were also raised about the “design, use of facilities, and equipment” in the hospital, with the watchdog saying it did not believe patients were always “safe”. In one instance, it was discovered the antenatal day unit had no neonatal resuscitaire - (a device used to give breathing support to babies when needed) - and no plan in place for how staff could access one in an emergency.

The CCQ also highlighted that there was no policy outlining how often staff should complete training, nor any information on which programmes were mandatory. Only 51% of staff were trained to assess foetal growth using the fundal height measurement, falling short of the trust target of 90%, and many others did not know how to evacuate a birthing pool in the event of an emergency.

Staff told inspectors they felt unsupported, explaining they were “not always listened to” and were “not provided with compassion and support from leaders” following incidents. “Issues” with staff shortages and sicknesses were also reported - as was the lack of an appraisal procedure which would ensure workers were competent in their roles.

Among other issues, medicines were not always stored securely, and records were often not kept up to date. The only positive notes made in the report were the fact that the maternity areas were clean, infection was controlled well, and recruitment was ongoing in an attempt to improve staffing issues.

A spokesperson said that Hull University Teaching Hospitals NHS Trust is “extremely disappointed” with the outcome of the inspection - and acknowledges the findings “in their entirety”.

They continued: “Since the inspectors visited we have reviewed all of the areas highlighted by the CQC, and we are taking immediate action to address the urgent issues raised in the report. What we see in this service are many good people, with busy jobs, doing their very best to try and deliver multiple, complex, and competing priorities.

“Part of our response has been to support and help our teams to improve their management of improvement actions and the governance of the service, and to strengthen the leadership in maternity.”

Since its rating was downgraded, the trust has appointed a number of new staff for additional support - including a head of midwifery, two additional matrons, a clinical director for maternity and neonates (newborns), and three consultants.

“This will ensure that pregnant people requiring urgent care are assessed rapidly and appropriately, and receive the care they need in a safe and timely way,” the spokesperson said.

They added: “Our maternity service is made up of dedicated and skilled clinicians and managers, all of whom are determined to address, rapidly, the areas of concern highlighted in this report. The whole team has united to develop a short, medium, and long-term strategy for improving maternity services.”